Scillia P, Delcroix M, Lejeune P, Mélot C, Struyven J, Naeije R, Gevenois P A
Department of Radiology, Erasme University Hospital, Brussels, Belgium.
Radiology. 1999 Apr;211(1):161-8. doi: 10.1148/radiology.211.1.r99ap07161.
To identify the hemodynamic determinants of ground-glass opacification on thin-section computed tomographic (CT) scans of hydrostatic pulmonary edema and to compare attenuation and subjective assessments of ground-glass opacification with extravascular lung water.
Left atrial pressure, pulmonary arterial pressure, effective pulmonary capillary pressure, and extravascular lung water were measured in six dogs before and during progressive increase of effective pulmonary capillary pressure. A thin-section CT scan was obtained at each step. Lung attenuation and subjective assessments of ground-glass opacification were compared with hemodynamic variables and extravascular lung water.
Ground-glass opacification was identified when effective pulmonary capillary pressure equaled critical pulmonary capillary pressure. Extravascular lung water increased, and the distribution curve of lung attenuation coefficients shifted to higher attenuation from the second measurement at an effective pulmonary capillary pressure greater than the critical pulmonary capillary pressure. Attenuation was highly correlated (r = 0.98, P < .001) with extravascular lung water; ground-glass opacification was detected before a significant (P = .615, analysis of variance) increase in extravascular lung water.
Thin-section CT depicts ground-glass opacification when effective pulmonary capillary pressure equals critical pulmonary capillary pressure and before a detectable increase in extravascular lung water. Attenuation reflects extravascular lung water.
确定在静水压性肺水肿的薄层计算机断层扫描（CT）上磨玻璃样混浊的血流动力学决定因素，并比较磨玻璃样混浊的衰减及主观评估与血管外肺水的关系。
在6只犬身上，于有效肺毛细血管压逐渐升高之前及过程中，测量左心房压、肺动脉压、有效肺毛细血管压及血管外肺水。在每个阶段获取薄层CT扫描图像。将肺衰减及磨玻璃样混浊的主观评估与血流动力学变量及血管外肺水进行比较。
当有效肺毛细血管压等于临界肺毛细血管压时，出现磨玻璃样混浊。血管外肺水增加，且在有效肺毛细血管压大于临界肺毛细血管压时，从第二次测量开始，肺衰减系数的分布曲线向更高衰减方向移动。衰减与血管外肺水高度相关（r = 0.98，P <.001）；在血管外肺水出现显著增加（P =.615，方差分析）之前即可检测到磨玻璃样混浊。
当有效肺毛细血管压等于临界肺毛细血管压且在血管外肺水出现可检测到的增加之前，薄层CT可显示磨玻璃样混浊。衰减反映血管外肺水。
